Provider Demographics
NPI:1487966461
Name:PALAKAWONG NA AYUDHYA, PILAIPORN (MD)
Entity type:Individual
Prefix:
First Name:PILAIPORN
Middle Name:
Last Name:PALAKAWONG NA AYUDHYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4100 HIGH RESORT BLVD SE
Mailing Address - Street 2:PRESBYTERIAN MEDICAL GROUP, ENDOCRINOLOGY
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-5901
Mailing Address - Country:US
Mailing Address - Phone:505-462-8888
Mailing Address - Fax:
Practice Address - Street 1:4100 HIGH RESORT BLVD SE
Practice Address - Street 2:PRESBYTERIAN MEDICAL GROUP, ENDOCRINOLOGY
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-5901
Practice Address - Country:US
Practice Address - Phone:505-462-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0761207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine